Indicated Prevention with At-Risk Gamblers

描述(由申请人提供)：这项研究的广泛、长期目标是通过开发有效的有针对性的预防技术，减少高风险赌博及其相关危害在人群中的流行。在美国，赌博代表着一种日益增长的、往往未被认识到的公共健康威胁，从青春期晚期到成年初期，这一年龄段是过度赌博的特别脆弱时期。9%-15%的大学生可以被描述为高风险赌徒，表现出一些赌博的后果，但还不符合DSM-IV的病态赌博标准。目前项目的主要目的是记录60-90分钟的个人反馈干预(PFI)与6节认知行为(CBT)小组干预和仅评估条件相比，在减少高危大学生赌徒(N=300)赌博行为和相关负面后果方面的效果，PFI包含动机访谈和简要技能元素，通过对UW大学新生(N=3000)的随机样本进行简短筛选，在资助期的第一年和第二年进行。第二个目标是评估干预效果的潜在调节因子和中介因子。缓和假设被指定为自决、赌博动机、准备改变和认知扭曲。中介假设被指定为准备改变、标准认知、认知扭曲和应对技能。风险赌徒(SOG得分3或以上，但不符合DSM-IV病态赌博标准)将在基线、干预后、基线后6个月和12个月进行评估。这项研究解决了赌博文献中的几个空白，包括缺乏关于指示预防的研究，缺乏针对赌博的PFI干预措施的先前疗效数据，缺乏针对弱势大学生的干预措施，以及很少有试验将CBT(特别是CBT组)与任何其他积极的赌博治疗进行比较。此外，几乎没有研究评估赌博干预效果的中介或调节因素。

DESCRIPTION (provided by applicant): The broad, long-term objective of this research is to reduce the prevalence of at-risk gambling and related harm in the population, through development of efficacious indicated prevention techniques. Gambling represents a rising and often unrecognized public health threat in the US, and the age range from late adolescence to early adulthood is a particular period of vulnerability for excessive gambling. Between 9-15 percent of college students can be characterized as at-risk gamblers, exhibiting some consequences of gambling but not yet meeting DSM-IV criteria for pathological gambling. The primary aim of the current project is to document the efficacy of a 60-90 minute Personal Feedback Intervention (PFI) incorporating Motivational Interviewing and brief skills elements in comparison to a 6-session Cognitive Behavioral (CBT) group intervention and an assessment only condition, in reducing gambling behavior and related negative consequences of at-risk college student gamblers (N=300), identified through brief screening of a random sample of UW freshmen (N=3000) conducted in years 1 & 2 of the grant period. A secondary aim is to evaluate potential moderators and mediators of intervention efficacy. Moderating hypotheses are specified for self-determination, gambling motives, readiness to change, and cognitive distortions. Mediating hypotheses are specified for readiness to change, normative perceptions, cognitive distortions, and coping skills. At-risk gamblers (SOGS score 3 or above but not meeting DSM-IV criteria for pathological gambling) will be assessed at baseline, post-intervention, 6- & 12-months post-baseline. The study addresses several gaps in the gambling literature, including lack of research on indicated prevention, lack of prior efficacy data on PFI interventions for gambling, a lack of interventions targeting the vulnerable college years, and few trials comparing CBT (especially group CBT) to any other active treatment for gambling. In addition, there is virtually no research evaluating mediators or moderators of gambling intervention efficacy.